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NPI Code Detail

MEDICARE: MRS. KIMBERLY DOHERTY H.I.S.

MEDICARE: MRS. KIMBERLY DOHERTY H.I.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist2891IL

General Provider Information

NPI Number : 1851914667
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY DOHERTY H.I.S.
Provider Business Mailing Address
First Line : 335 N MILWAUKEE AVE
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1561
Country : US
Telephone Number : 847-883-8360
Fax Number :
Provider Business Practice Location Address
First Line : 335 N MILWAUKEE AVE
Second Line :
City : VERNON HILLS
State : IL
Zip : 60061-1561
Country : US
Telephone Number : 847-883-8360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2020
Last Update Date : 05/27/2020

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Directions to “ MRS. KIMBERLY DOHERTY H.I.S.” Practice Location

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